Provider Demographics
NPI:1255469698
Name:KLINGER, CHARLES W (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:KLINGER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12690 COUNTY ROAD 20
Mailing Address - Street 2:
Mailing Address - City:WEST UNITY
Mailing Address - State:OH
Mailing Address - Zip Code:43570-9722
Mailing Address - Country:US
Mailing Address - Phone:419-924-2536
Mailing Address - Fax:
Practice Address - Street 1:102 W. JACKSON ST.
Practice Address - Street 2:
Practice Address - City:WEST UNITY
Practice Address - State:OH
Practice Address - Zip Code:43570
Practice Address - Country:US
Practice Address - Phone:419-924-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-14434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist